ORLANDO - HIMSS President and CEO Hal Wolf officially opened HIMSS24 on Tuesday morning with a call to action for the 30,000 attendees from all corners of the globe and all facets of the healthcare ecosystem.

"If you don't like change, you're not going to like healthcare," he said. "This is not the place to sit if you don't enjoy an environment of improvement and an opportunity to recognize that digital health continues to progress and that each and every one of you has an incredibly important hand in it."

From a global pandemic to the rise of generative AI, it's been a fast few years of rapid change for healthcare, but Wolf said the speed of the industry's response has to be maintained.

"The question that keeps driving all of us a little bit is our speed of adoption where it needs to be," he said. "Given all the challenges that continue to hit us in healthcare, when we think about the fundamental progress that we're making, which is good, what you're going to hear a lot of in 2024, and get your ears attuned to it, is, of course, how do we quicken the pace? How do we create new tools and develop them in such a way that we can actually move our operational and our patient considerations forward as fast as we can?"

Because the challenges facing healthcare in the U.S. and around the world are not getting any easier to manage, said Wolf.

"All across the ecosystem, our populations are going to continue to age. And there's no question that we have staff shortages that are impacting each and every system globally. And funding levels are going to stay under assault. There is not going to be a tidal wave of money to sweep in and sort of help things along.

"We know that business as usual just isn't possible," he added. "The encounter-based paradigm we all grew up with just simply doesn't work mathematically. There's too many patients, too many needs and, frankly, not enough clinicians. There isn't a single healthcare system that isn't going to struggle on a daily basis to support and operate what it needs."

'Sustainability across everything we do'

So this year, HIMSS is prioritizing a one-word concept: Sustainability.

It's a "new word that has now crept into our lexicon, directly and boldly – and appropriately," said Wolf, who described three different areas where it must be put to work: sustainability of practice, sustainability of delivery systems and sustainability of the environment.

• "Twenty years ago, we talked about the sustainability of the practice of primary care," Wolf explained about the first concept. "We were introducing chat, we were introducing text messages, we were introducing video – and we were very concerned about the sustainability of primary care to be able to handle this influx of new communication channels with our patients. Those challenges are still here today. We still have to embrace the new tools, the new capabilities and the fundamentals in multiple disciplines where we're putting pressure each day."

• As for the sustainability of large health systems, many of them, even the biggest and most well-resourced, "cannot seem to find a clear strategic path forward in the current circumstances to change the care model quick enough in order to be able to meet the needs of their populations," said Wolf. One way forward is to embrace new data that will be brought into health systems from the home, from devices and remote monitoring, "information that we didn't have before," he said. "Outside in is a critical path to system sustainability." 

• The third, arguably most important, area is the sustainability of the environment. "And this is a really critical component in regards to carbon emissions," said Wolf. "When you look at some of the experts, we recognize that fundamentally, 8.5% of carbon emissions in the United States is generated by the health industry, and 5.2% globally. So we have an opportunity and a critical responsibility, and currently it is being incentivized, and on a volunteer basis, but it's here."

In the end, all three areas must be brought together to "create sustainability across everything we do, between the medical model and the health model, our patients and outside in," said Wolf. "This is the critical challenge from a strategic standpoint that is hitting all across the globe.

"But this is where we get excited at HIMSS over our new Infrastructure Maturity Model, or INFRAM," he added. "Because what we're doing now is recognizing that the environmental components have now been added into cybersecurity, the fundamentals of infrastructure adoption, performance and outcomes."

Artificial intelligence, of course, will have an enormous role to play too.

"We have a tendency to paint AI with just a single brush, and it's not," says Wolf, who listed the three big AI subsets, as he sees them.

"One is the small devices and applets. The second one, which we're seeing huge traction on, is in operational applications to manage and improve throughput. Third are the higher-level applications that start to use and get into the components of clinical decision support."

But for anyone looking for technology – even a fast advancing one like AI – to "solve all of our problems, it simply won't happen," said Wolf. "Technology alone doesn't do anything. It's people, process and technology. All three have to come together. Because if we can't figure out the right way to integrate AI, it's not going to land."

'We need radical transformation'

Wolf introduced the next of the morning's keynote speakers, Robert C. Garrett, CEO of New Jersey-based Hackensack Meridian Health.

"Harnessing AI will be one of the defining tasks, I believe, of the 21st century," said Garrett.

Guided by the appropriate people and processes, he said, "it may help us cure cancer or extend life and personalized treatment so that it becomes as unique as your fingerprint in healthcare today."

And not a moment too soon.

"We need radical transformation," said Garrett. "We must build the health system of the future, where people have seamless connections to care, a greater focus on prevention and wellness, and the chance to achieve their best health, regardless of where they live or the color of their skin. AI and industry partnerships have the potential to improve health for billions, and I mean billions of people."

Garrett recently returned from the World Economic Forum in Davos, Switzerland, where healthcare leaders were most focus on four imperatives, he said – all of which could be fundamentally addressed by fine-tuned AI applications:

• Improving access.

• Improving outcomes and providing better value.

• Health equity.

• Climate change impact on health.

"Improving access to health care in underdeveloped countries or in rural parts of the United States, I'm always struck by the statistic that one out of four people do not have a primary care physician – and if you're under 30, that number is one out of two," said Garrett. "So there's no question that access to care is a big issue that I believe AI can help us really improve people's access to good health care.

"The second priority was improving outcomes and providing better value to the healthcare system," he added. "When I think about what AI can do in terms of predictive analytics and predicting the onset of disease much quicker, allowing clinicians to have tools that can provide more personalized treatment, and the fact that AI can provide more efficiencies in healthcare and ultimately make healthcare more affordable, that's creating real value.

"The third priority was health equity," he said. "And there's no question in my mind that AI can help to drive health equity if it's done correctly and if it's governed well. I think about health equity in terms of even identifying the social determinants of health. Who's at risk for one of our social determinants of health? How can we really address that? By linking people who have those exposures to great care and to great resources, AI can really bridge that gap and hopefully close some of the disparities that exist in healthcare outcomes today."

Finally, Garrett made special note of the last priority: climate change.

"You heard a little bit about sustainability and climate change even a few minutes ago," he said. "And there's no doubt in my mind that AI can help us identify major events in the climate and really give us the tools to help address some of the effects of climate change.

"Between the years 2000 and 32,050, climate change is expected to cause an additional 250,000 deaths per year from conditions like asthma, and malnutrition, and malaria," Garrett added. "One in four people are now living under drought conditions around the world. AI can drive new solutions to limit pollutants, improve energy efficiency, and help create more renewable sources."

Aligning incentives, finding ROI

Garrett and Wolf were then joined onstage by Matt Renner, president at Google Cloud.

"It's been an amazing year: Obviously, the rise of generative AI has really gotten a lot of focus," said Renner with some understatement. "But a lot of what we're seeing here in the landscape has been a kind of settling in, a year later."

Thousands of AI proofs of concepts have been launched at healthcare organizations of all shapes and sizes, with an eye toward tackling any number of challenges.

"But most of them have not made it to production – meaning they've gone to their end state and they're out being used in the public," said Renner.

"Some of the reasons for that are tied to data, data structures, meaning that some of the things they targeted or got into were a little bit more hectic than they expected," he said. "But another main reason was it just maybe didn't have the best business case. It wasn't going to be making sense to invest, to take that to production."

There are other fundamental AI challenges too, of course, that were discussed at length by Wolf, Garrett and Renner: data governance, data privacy, "hallucinations," etc.

But for all the hard work, the effort to get AI deployments right is undoubtedly worth it. One factor for success – for clinical or operational or financial ROI, for a successful business case, is "something that's productive for patients, for doctors," said Renner.

Indeed, the potential for AI, judiciously applied, to help some of healthcare's longest-standing problems is immense.

Garrett ran the numbers: "90% of all health care costs in the U.S. go toward treating chronic illness," he said. "That represents $3.7 trillion a year. And as we work to turn the tide, there's another looming challenge. By the year 2050, the number of people 60 and older globally will double, creating unprecedented demand for care. At the same time, we're likely to have a significant shortage of caregivers.

"The power of AI in healthcare is fundamentally tied to the quality, accessibility and standardization of data," he said. "AI algorithms are creating the rapid analysis of health data, leading to precise diagnoses and timely interventions. Predictive models powered by AI can detect patterns and trends aiding disease prevention and personalized treatment. All around the globe, there's tremendous promise in what AI can do."

Mike Miliard is executive editor of Healthcare IT News
Email the writer: mike.miliard@himssmedia.com
Healthcare IT News is a HIMSS publication.